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Publications

Scottish Health Boards' Dental Epidemiological Programme

Report of the 1999/2000 Survey of 5 Year Old Children

Executive Summary

Prepared by:

N B Pitts, Z J Nugent and P A Smith
Dental Health Services Research Unit,
University of Dundee

Introduction

The Scottish Health Boards' Dental Epidemiological Programme (SHBDEP) is a joint venture between all fifteen Health Boards (represented through the Chief Administrative Dental Officers/Consultants in Dental Public Health Group) and the Chief Scientist Office's Dental Health Services Research Unit based at the University of Dundee. Standardised surveys are undertaken on randomly selected samples of children across Scotland using the criteria and timetable agreed by the British Association for the Study of Community Dentistry (BASCD). This enables Boards to compare their own results with other areas of Scotland and with other parts of the UK. These surveys are essential for monitoring progress towards government targets for dental health, the most recent set out in the White Paper "Towards a Healthier Scotland" in 1999.

Aim

The aim of this year's survey was to determine current experience of tooth decay (dental caries) in 5 year old children in Scotland, to provide a simple baseline population measure of levels of oral cleanliness and to illustrate the impact of deprivation on the dental health of this age group; these results are summarised below. Full details can be found in the main Report.

Key Results

Dental caries experience (d3mft) for Scotland: The overall result of a mean number of decayed (d3), missing (m) and filled (f) teeth (t) per child of 2.55 is considerably higher than the means of 1.64 for Great Britain and 1.68 for the UK which were recorded in the BASCD surveys of 1997/98. The Care Index (ft/d3mft) reveals that only 9.4% of the dentinal caries experience was recorded as fillings (ft=0.24). The map opposite (Figure J2 in Appendix J of the Report) shows the variation in the distribution of caries experience across Scotland. Dental caries experience (d3mft) for individual Health Boards: The figure below (Figure 1 in the Report) shows the mean d3mft for each Health Board and the 95% confidence intervals associated with each mean. The size of the error bars indicate the limited extent to which this figure can be interpreted as a simple "league table"; overlapping error bars indicate differences that are not statistically significant.

Mean number of decayed, missing and filled teeth (d₃mft) per child for each Health Board (decay defined as decay into dentine).

The proportion with "caries experience" and the pattern of attack: Only 45% of 5 year olds were found to be "free" of dental decay experience at the caries into dentine level of detection (that is decay penetrating beyond the enamel surface of teeth). The range across the fifteen Health Boards was from 34% to 65%.

Percentage with dentinal caries or past caries experience in each Health Board.

Trends over time: The overall (d₃mft) results from the six previous SHBDEP surveys of this age group indicated that the decline in levels of decay seen previously had halted in the late 1980s; the results of this survey are in line with this scenario. The Care Index (ft/d3mft) has risen slightly to 9.4% from the previous survey. The proportion of children "free" of caries experience at the dentinal level has improved marginally but still falls far short of the National Target of 60% originally set for the year 2000 and now extended to 2010.

Deprivation : The strong association between deprivation and dental disease which was seen in the 1997/98 Survey is still apparent in this year's results, see figure opposite (Figure 7 in the Report). Four times as many children in DEPCAT groups 6 and 7 (most deprived) require extractions or endodontics compared with children in DEPCAT groups 1 and 2 (least deprived).

Uneven distribution of decay: All of the decaying teeth (d3t) were found in 50% of the children (a finding which is very similar to the results for Scottish 5 year olds from the UK survey conducted by the Office of Population Censuses and Surveys in 1993). Some of these children had very high disease levels; half of the untreated decayed surfaces were found in just 9% of the children, an identical figure to that in the last survey.

Prevalence of abscesses: Of the 6994 children attending Primary 1 in schools in Scotland who took part in the SHBDEP survey, abscesses were found in 4.8% (334). While approximately 2% of children from the most affluent parts of Scotland have abscesses, nearly 11% in the poorest areas suffer in this way.

More detailed information is available in the full Report. Copies can be obtained from the Dental Health Services Research Unit, Dental School, Park Place, Dundee DD1 4HR (price £10 per copy). For local information please contact the Chief Administrative Dental Officer/ Consultant in Dental Public Health at the relevant Health Board.

Return to Report of the 1999-2000 Survey of 5 Year old Children homepage.